Chief Leschi Schools of the Puyallup Tribe of Indians (PDF)
U.S. Department of Education Washington, D.C. 20202-5335
•
APPLICATION FOR GRANTS UNDER THE
Application for New Grants Under the Elementary and Secondary School Counseling Program
CFDA # 84.2 1SE
PR/Award# S2JSEl40513
Gramts.gov Tracking#: GRANT I 1638534
OMB No. 1894-0006, Expiration Date:. I l/30nOJ4
Closing Dare: Apr28~Wt4
PR/Award# S215E1405 l3 **Table of Contents**
Form Page
1. Application for Federal Assistance SF-424 e3
2. Assurances Non-Construction Programs (SF 424B) e6
3. Disclosure Of Lobbying Activities (SF-LLL) ea
4. ED GEPA427 Form e9
5. Grants.gov Lobbying Form e10
6. ED Abstract Narrative Form e11
Attachment - 1 (1234-CLS ESSCoOne page abstract) e12
7. Project Narrative Form e13
Attachment- 1 (1238-Uploaded narrative CLS ESSC grant CFDA 84.215E 4-28-14) e14
8. Other Narrative Form e39
Attachment- 1 (1236-TABLE OF CONTENTS) e40
Attachment- 2 (1237-resumes final routed and submitted Elementary Counseling grant May 5-25-12 pdf) e41
9. Budget Narrative Form e58
Attachment- 1 (1235-CLS Budget Narrative ESSC uploaded 4-28-14) e59
10. Form ED_524_ Budget_ 1_2-V1.2.pdf e66
11 . Form ED_SF424_Supplement_1_2-V1.2.pdf e68
This application was generated using the PDF functionality. The PDF functionality automatically numbers the. pages in this application. Some pages/sections of this application may.contain 2 sets of page numbers, one. set created. by the applicant and. the other. set created by a-Application's PDF. functionality. Page numbers. created by the. e·Application PDF functionality will be preceded by the letter e (for example, et , e2, e3, etc.).
Page e2 OMB Number: 4040-0004 Expiration Date: 8/31/2016
Application for Federal Assistance SF-424
• 1. Type of Submission: • 2. Type of Application: ·If Revision, select appropriate letter(s): 0 Preapplication ~ New I I ~App li cation O Continuation • Other (Specify): 0 Changed/Corrected Application 0 Revision I I
• 3 .. Date Received: 4. Applicant Identifier: 104/2812014 I I I
5a. Federal Entity Identifier: 5b. Federal Award Identifier: I I I I
State Use Only: 6. Date Received by State: I I 17. State Application Identifier: I I 8. APPLICANT INFORMATION:
•a. Legal Name: !chief Leschi Sc hools of the Puyallup Tribe of Indians I • b .. Employer/Taxpayer Identification Number (EIN/TIN): • c. Organizational DUNS: 1911597976 I 18354 993850000 I
d .. Address:
• Street1 : 15625 52nd St . E . I Street2: I I •City: !Puyallup I County/Parish: I I · State: I WA : Washi ngton I Province: I I •Country: I USA : UNITED STATES I • Zip I Postal Code: 198371- 3610 I e. Organizational Unit:
Department Name: Division Name: I I I I
f. Name and. contact information of person to be contacted on matters involving this application:
Prefix: I I • First Name: !Nor man I Middle Name: I I •Last Name: loorpat I Suffix: I I Title: !Grants and Compl ianc e Officer I Organizational Affiliation: I I •Telephone Number: 1253- 606-7578 I Fax Number: I I • Email: lnorm@ l esc hisc hool s . org I PR/Award# S215E140513 Page e3
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 Application for Federal Assistance SF-424
* 9. Type of Applicant 1: Select Applicant Type: I : Indian /Native American Tribal Government (Feder ally Recognized) I Type of Applicant 2: Select Applicant Type: M: Nonprof it with 501C3 IRS Status (Other than Insti tuti on o f Higher Educati on) I Type of Applicant 3: Select Applicant Type: Ix:. Other. ( specify) I * Other. (specify): IB . I . E .. Grant School I
* 10. Name of Federal Agency: lu.s . Department o f Education I 11 . Catalog of Federal Domestic Assistance Number: 184 . 2 15 I CFDA Title:
IFund f or. the. Improvement. o f. Education I * 12. Funding Opportunity Number: IED - GRANTS - 031214-001 I *Title:
Office. o f. Elemen tary. and Secondary. Education (OESE) :. Elementary. and Secondary. School. Counseling. (ESS C) Program CFDA Number. 84 . 215E
13. Competition Identification Number: 184- 215E2014- l I Title:
14. Areas Affected by Project (Cities, Counties, States, etc.): I Add Attachment I Delete Attachment I View Attachment I
* 15. Descriptive Title of Applicant's Project: " Pulling Togethe r" Community School s Partne rship
Attach. supporting documents as specified in agency instructions. Add Attachments J , Delete Attachments ] '· View Attachments I
PR/Award# S215E140513 Page e4
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 Application for Federal Assistance SF-424
16. Congressional Districts Of: • a. Applicant j10 I • b. Program/Project j10 I Attach an additional list of Program/Project Congressional Districts if needed. I I Add Attachment I r Delete Attachment I View Altachrnent I 17. Proposed Project: • a. Start Date: 109/ 01/2 0141 • b. End Date: 108/31/20 171
18. Estimated Funding ($): •a. Federal I 399 , 622 .ooi • b. Applicant I o.ool * c. State o.ooi • d. Local o.ooi • e. Other o.ooi • f. Program. Income o. ool 'g.TOTAL 399 , 622 .ooi
* 19. ls Application Subject to Review By State Under Executive Order 12372 Process? D a. This application was made available to the. State under the Executive Order 12372 Process for review on I I· D b. Program is subject to E.O. 12372 but has not been selected by the State for review. IZl c. Program is not covered by E.O. 12372.
• 20. Is the. Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) o ves iZI No If "Yes", provide explanation and attach. I I Add Attachment I Delete Attachment I View Attachment I 21 . *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances•* and agree to comply with any resulting terms if I acc,ept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to. criminal, civil, or. administrative penalties. (U.S. Code, Title 218, Section 1001) iZI *' I AGREE •• The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific. instructions.
Authorized Representative: Prefix: I I * First Name: !Raymond I Middle Name: I I •Last Name: !Lorton I Suffix: I I * Title: !superintendent I •Telephone Number: 14-25 -14 I Fax Number: I I • Email: lray@ l eschi school s . org I • Signature of. Authorized. Representative: IUnhi Pak I • Date Signed: 104/2812014 I
PR/Award# S215E140513 Page e5
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 OMB Number: 4040-0007 Expiration Date: 06/30/2014
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PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1 . Has the legal authority to apply for Federal assistance Act of 1973, as amended (29 U.S.C. §794),. which and the institutional, managerial and financial capability prohibits discrimination on the basis of handicaps; (d) (including funds sufficient to pay the non-Federal share the Age. Discrimination Act of 1975, as amended (42. U. of project cost) to ensure proper planning, management S.C. §§6101-6107), which prohibits discrimination on and completion of the project described in this the basis of age;. (e) the Drug Abuse Office and application. Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug 2. Will give the awarding agency, the Comptroller General abuse; (f) the Comprehensive Alcohol Abuse and of the United States and, if appropriate, the State, Alcoholism Prevention,. Treatment and Rehabilitation through any authorized representative, access to and Act of 1970 (P.L. 91 -616), as amended, relating to the right to examine all records, books, papers, or nondiscrimination on the basis of alcohol. abuse or documents related to the award; and will establish a alcoholism; (g) §§523 and 527 of the Public Health proper accounting system in accordance with generally Service. Act of 1912. (42 U.S.C. §§290. dd-3 and 290 accepted accounting standards or agency directives. ee- 3) , as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil. 3. Will establish safeguards to prohibit employees from Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as using their positions for a purpose that constitutes or amended, relating to nondiscrimination in the sale, presents the appearance of personal or organizational rental or financing of housing; (i) any other conflict of interest, or personal gain. nondiscrimination provisions in the. specific statute(s). under which application for Federal assistance is being 4. Will initiate and complete the work within the applicable made; and, 0). the requirements. of any other time frame after receipt of approval of the awarding nondiscrimination statute(s) which may apply to the agency. application. 7. Will comply, or has already complied, with the 5. Will comply with the Intergovernmental Personnel Act of requirements of Titles II and Ill of the Uniform 1970 (42 U.S.C. §§4728-4763} relating to prescribed Relocation Assistance and Real Property Acquisition standards for merit systems for programs funded under Policies Act of 1970 (P.L. 91 -646) which provide for one of the 19 statutes or regulations specified in fair and equitable treatment of persons displaced or Appendix A of OP M's Standards for a Merit System of whose property is acquired as a result of Federal or Personnel Administration (5 C.F.R. . 900, Subpart F). federally-assisted programs. These requirements apply to all interests in real property acquired for 6. Will comply with all Federal statutes relating to project purposes regardless of Federal participation in nondiscrimination. These include but are not limited to: purchases. (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color 8. Will comply, as applicable, with provisions of the or national origin; (b) Title IX of the Education Hatch Act (5 U.S.C. §§1501 -1508 and 7324-7328) Amendments of 1972, as amended (20 U.S.C.§§1681- which limit the political activities of employees whose 1683, and 1685-1686), which prohibits discrimination on principal employment activities are funded in whole the basis of sex; (c) Section 504 of the Rehabilitation or in part with Federal funds.
Previous Edition Usable Standard Form 4248 (Rev. 7-97) Authorized for Local Reproduction Prescribed by OMB Circular A-102
PR/Award# S215E140513 Page e6
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 9. Will comply, as applicable, with the provisions of the Davis 13. Will assist the awarding agency in assuring compliance Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act with Section 106. of the National Historic Preservation (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Act of 1966, as amended (16 U.S.C. §470), EO 11593 Work Hours and Safety Standards. Act (40 U.S.C. §§327- (identification and protection of historic properties), and 333), regarding labor standards for federally-assisted the Archaeological and Historic Preservation Act of construction subagreements. 1974 (16 U.S.C. §§469a-1 et seq.).
1O. Will comply, if applicable, with flood insurance purchase 14. Will comply with P.L. 93-348. regarding the protection of requirements of Section 102(a) of the Flood Disaster human subjects involved in research, development, and Protection Act of 1973 (P.L. 93-234) which requires related activities supported by this award of assistance. recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of 15. Will comply with the Laboratory Animal Welfare Act of insurable construction and acquisition is $10,000 or more. 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et seq.) pertaining to the care, handling, and treatment of 11 . Will comply with environmental standards which. may be warm blooded animals held for research, teaching, or prescribed pursuant to the following: (a) institution of other activities supported by this award of assistance. environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and 16. Will comply with the. Lead-Based Paint Poisoning Executive Order (EO) 11514; (b) notification of violating Prevention Act (42 U.S.C. §§4801 et seq.) which facilities pursuant to EO 11738; (c) protection of wetlands prohibits the use. of lead-based paint in construction or pursuant to EO 11990; (d) evaluation of flood hazards in rehabilitation of residence structures. floodplains in accordance with EO 11988; (e) assurance of 17. Will cause to be performed the required financial and project consistency with. the approved State management compliance audits in accordance with the Single Audit program developed under. the Coastal Zone Management Act Amendments of 1996. and OMB Circular No. A-133,. Act of 1972. (16 U.S.C. §§1451 et seq.); (f) conformity of "Audits of States, Local Governments, and Non-Profit Federal actions to State (Clean Air) Implementation Plans Organizations." under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of 18. Will comply with all applicable requirements of all other underground sources of drinking water under the Safe Federal. laws,. executive orders, regulations, and policies Drinking Water Act of 1974, as amended (P.L. 93-523); governing this program. and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P .L. 93- 19. Will comply with the requirements of Section 106(g) of 205). the Trafficking Victims Protection Act (TVPA) of 2000, as amended (22 U.S.C. 7104) which prohibits grant award 12. Will comply with the Wild and Scenic Rivers Act of recipients or a sub-recipient from (1) Engaging in severe 1968 (16 U.S.C. §§1271 et seq.) re lated to protecting forms of trafficking in persons during the period of time components or potential components of the national that the award is in effect (2) Procuring a commercial wild and scenic rivers system. sex act during the period of time that the award is in effect or (3) Using forced labor in the performance of the award or subawards under the award.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE lunhi Pak I !superintendent I APPLICANT ORGANIZATION DATE SUBMITIED khief Leschi School s of the Puyallup Tribe of Indians I lo4 /28/2014 I
Standard Form 4248 (Rev. 7-97) Back
PR/Award # S215E140513 Page e7
Tracking Number: GRANTI 1638534 Funding Opportunity Number: ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 0348-0046
1. *Type of Federal Action: 2. * Status of Federal Action: 3. * Report Type: D a. contract D a. bid/offer/application IZJ a. initial filing IZJ b.grant IZJ b. initial award D b. material change D c. cooperative agreement D c_ post-award D d. loan D e. loan guarantee D f. loan insurance 4. Name. and Address of Reporting Entity: IZJ Prime D SubAwardee "Name lchief Leschi Schools I ·Street 1 Street 2 I 15625 52nd st . E. I I "City State Zip IPuyallup I lw1\ :. Washington I 1984232 I Congressional District, if known: I10 I 5. If Reporting. Entity in No.4 is. Subawardee, Enter. Name and Address of Prime:
6. * Federal Department/Agency: 7. * Federal Program Name/Description: joepartment of Education I IFund for the Improvemen~ of Education I CFDA Number, if applicable: ls4 . 21s I 8. Federal Action Number, if known: 9. Award Amount, if known: I I $I I 10. a. Name and Address of lobbying Registrant:
Prefix I • First Name I Middle Name I I N/A I I ·Last Name IN/A I Suffix I I ·Street 1 I I Street 2 I I "City I I State I I Zip I I
b. Individual Performing Services (including address if different from No. 1oa)
Prefix 1 ·First Name IMiddle Name I IN/A I I "LastName l1-1 tl\ I Suffix I I •Street 1 I I Street 2 I I 'City I I State I I Zip I I 11. Information requested through this lorm is authorized by title 3 1 U.S.C. section 1352. . This disclosure of lobbying activities is a material representation ol lact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This. information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure. shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
• Signature: lunh l Pak I *Name: Prefix I '. First Name I Middle. Name I I Rayjond I I " LastName Suffix ILorto n I I I Title: lsupt . I Telephone No.: I loate: lo412s12014 I I Authorized tor Local Reproduction Federal Use Only: Standard Form - LLL (Rev. 7-97) - f 111 ,-.-.1..u""' ft ...... I v ._ I cvv I .J Page e8
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 OMB Number: 1894-0005 Expirati on Date: 03/31/201 4 NOTICE TO ALL APPLICANTS
The purpose of this enclosure is to inform you about a new description of how you plan to address those barriers that are provision in the Department of Education's General applicable to your circumstances. In addition, the information Education Provisions Act (GEPA) that applies to applicants may be provided in a single narrative, or, if appropriate, may for new grant awards under Department programs. This be discussed in connection with related topics in the provision is Section 427 of GEPA, enacted as part of the application. Improving America's Schools Act of 1994 (Public Law (P.L.) 103-382). Section 427 is. not intended to. duplicate the. requirements of civil rights statutes, but rather to ensure that, in designing To Whom Does This Provision Apply? their projects, applicants for Federal funds address equity concerns. that may affect the ability of certain potential Section 427 of GEPA affects. applicants for new grant beneficiaries. to fu lly participate in the project and to achieve awards under this program. ALL APPLICANTS FOR to high standards. Consistent with program requirements and NEW AWARDS MUST INCLUDE INFORMATION IN its. approved application, an applicant may use the. Federal THEIR APPLICATIONS TO ADDRESS THIS NEW funds awarded to it to eliminate. barriers it identifies. PROVISION IN ORDER TO RECEIVE FUNDING UNDER THIS PROGRAM. What are Examples of How an Applicant Might Satisfy the Requirement of This Provision? (If this program is a State-formula grant program, a State The. following examples may help illustrate how an applicant needs to provide this description only for projects or may comply with Section 427. activities that it carries out with funds reserved for State-l evel uses. In addition, local school districts or other eligible (1) An applicant that proposes to carry out an adult literacy applicants that apply to the State for funding need to provide project serving, among others, adults with limited English this description in their applications to the State for funding. proficiency, might describe in its application how it intends to. The State would be responsible for ensuring that the school distribute. a brochure about the proposed project to such district or other local entity has submitted a sufficient potential participants in their native. language. section 427 statement as described below.) (2) An applicant that proposes to develop instructional materials. for. classroom use might describe how it will. make What Does This Provision Require? the materials available on audio tape or in braille. for. students Section 427 requires each applicant for funds (other than an who. are blind. individual person) to include in its application a description of the steps the applicant proposes to take to ensure (3) An applicant that proposes to carry out a model science equitable access to, and participation in, its program for secondary students and. is concerned that girls Federally-assisted program for students, teachers, and may be. less like ly than boys to enroll in the course, might other program beneficiaries with special needs. This indicate how it intends to conduct "outreach" efforts to girls, provision allows applicants discretion in developing the to encourage their enrollment. required description. The statute highlights six types of barriers that can impede equitable access or participation: gender, race, national origin, color, disability, or age. We recognize that many applicants may already be Based on local circumstances, you should determine implementing effective steps to ensure equity of whether these or other barriers may prevent your students, access and participation in their grant programs, and teachers, etc. from such access or participation in, the we appreciate your cooperation in responding to the Federally-funded project or activity. The description in your requirements of this provision. application of steps to be taken to overcome these barriers. need not be lengthy; you may provide a clear and succinct
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Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001. Received Date:2014-04-28Tl 5:31 :37-04:00 CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influ encing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form·LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.
(3) The undersigned shall require that the language ot this certification be included in the award documents. for. all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose. accordingly. This certification is a material representation ot fact upon which reliance was placed when this transaction was. made or entered into. Submission of this. certification is a prerequisite for making or entering into this. transaction imposed by section 1352, title. 31 , U.S .. Code .. Any person who fails to. file the required certification shall be. subject to a civil penalty ot not less than $10,00 0 and not more than $100,000 for each such failure ..
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and belief, that:
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31 , U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
•APPLICANT'S ORGANIZATION !chief Leschi Schools of the Puyallup Tribe of Indians I
•PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Prefix: J I • First Name: JRaymonct I Middle Name: I I • Last Name: ILorton I Suffix: I I '.Title: Jsuperintendent I
*SIGNATURE: Junhi Pak I 'DATE: Jo4/28/2014 I
PR/Award# S215E140513 Page e10
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 Abstract The abstract narrative must not exceed one page and should use language that will be understood by a range of audiences. For all projects, include the project title (if applicable), goals, expected outcomes and contributions for research, policy, practice, etc. Include population to be served, as appropriate. For research applications, also include the following:
• Theoretical and conceptual background of the. study (i.e., prior research that this investigation builds upon and that provides a compelling. rationale for this study)
Research issues, hypotheses and questions being addressed
• Study design including a brief description of the. sample including sample size, methods, principals dependent, independent, and control variables, and the approach to. data analysis.
(Note: For a non-electronic submission, include the name and address of your organization and the name, phone number and e-mail address of the contact person for this project.)
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• Attachment: lcLS ESSCoOne page abstract.pd! Add Attachment Delete Attachment I View Attachment
PR/Award# S215E140513 Page e1 1
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001. Received Date:2014-04-28Tl 5:31 :37-04:00 ESSC ABSTRACT- Chief Leschi Schools Partnership: Objectives and Activities :. Our
partnership will collaborate in expanding counseling services in elementary grades preschool - six
by developing direct and referral based mental health related services. We will measurably close
gaps in existing capacity (GPRA 1). Social work, school psychology services, and related mental
health services will be expanded across three sites that serve a primarily urban Native American
population on and near the Puyallup reservation (Tacoma, Washington). New mental health
provider (and related) partnerships will be established and existing partnerships will be
strengthened. Increased capacity to provide school and community based links and long-term
connections to those providers will be prioritized. This will lead to an increase in protective
factors, e.g., school and community attachment. Associated reduction in risk indicators will be
evidenced, e.g., a reduction in student discipline rates (GPRA 2) and child neglect I abuse reports.
Applicable priorities: Priority One: (a) Improving school environment, and (b) school safety are
specifically woven into our project design. For example, our partnership with the Puyallup Tribal
Police (GREAT program) and related school safety measures will be strengthened. Priority Two:
Support for military connected students is explicitly designed into our proposal.
Project Outcomes: Tribal, military, and non-tribal community mental health services are.
present in our community, but many of our high-needs families do not access those services. Yet
our students and their families are engaged with our tribal community schools. Embedding
mental health services in our community school setting will 1) increase school based mental
health services to students, and 2) connect students and families to long term or more intensive
therapeutic services. with local mental health providers. An improved referral process and case
management support will provide support for high risk project participants. Sustained and job-
embedded professional development will help build long-term capacity for related classroom
based emotional supports for students. School environment improvements (school safety) will be
linked to social competence. and anti-bullying programming.
Numbers served and proposed sites: Approximately 800 students will be served in two elementary
schools (defined as P - 6 per the Tribally Controlled Schools Act): Chief Leschi School (675,
includes GELC preschool through M.O.A.) and Wa He Lut elementary grades k-6 (125).
Chief Leschi Schools Partnership for ESScµR/Award # s215E140513 Abstract Page e1 2 Close Form
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Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 Pulling Together: Building a Strong Tradition": (1.A) Need for the project (20 Points), extent to which specific gaps or weaknesses ..... Most of our students live on or near the Puyallup reservation which encompasses a high-poverty core in Tacoma, Washington (Enterprise
Community). This project will serve students. in grades P-6 in Chief Leschi Schools (CLS) and in
Wa He Lut school). CLS and Wa He Lut are governed as LEAs ( 20 USC, 7801 et seq., pt. A, definitions, sec. 9101, (26)(A)), and also per state RCW 28A .. We. will intentionally address specific gaps in services, infrastructure and opportunities as follows:
Service. Gaps: Although counseling is present in our elementary school programs, on-site and integrated referral based mental health services are not present. We will establish comprehensive mental health services in our schools. Improved linkages with tribal and community mental
health based providers will be established. We will intentionally build a network of supports that explicitly address student risk factors. These include. extreme. economic. deprivation, poor school and community attachment, family management problems leading to conflict and dissolution.
Early and favorable attitudes toward problem behaviors, such as gang membership result.
Community risk factors lead to school based issues of persistent antisocial behavior and lack of
attachment.. These factors in turn directly impact student attendance and achievement.
Infrastructure: We will address service gaps by building on the existing "infrastructure" of our academic response to intervention program (A-RTI) by establishing a fully developed behavioral response to intervention (B-RTI early intervention) program. A system of direct, contracted, and referral based services will be established to meet the deep needs of our urban Indian families.
Opportunities: Improved achievement will result from proactively building student protective factors. We will measurably improve bonding and attachment, social I emotional competence,
positive cultural and self-identity, and opportunities for pro-social involvement of students and
Chief Leschi. Schools Elementary School Counseling Proposal, CFDA 84.215E page l . PR/Award# S215E140513 Page e14 families together in our community tribal school setting. Parent I community involvement is woven into all aspects of our project. We will conduct project activities in the home, school and community. Our tribal school mission directly supports this . . The success of our project will demonstrate the viability and effectiveness of school based mental health supports to increase
protective. factors and reduce risk factors, all provided in the context of community and culture.
Nature and Magnitude of Gaps and Weaknesses: GPRA 1 gap analysis is described below:
Table l, GPRA 1: Calculation Number Number Number Number of Closing the gaJ! ... of Service of of of School Qualified (ratios based on statute Gap (2013- Child- School Social Mental where applicable and 2014 adolescent Psych- Workers Health local needs baseline psychia- ologists Profes- assessment). data) trists sionals, 2013-2014 Enrollment: Baseline FfE 0.0 FfE .2FfE O.OFfE OFfE approx. 650 students Statute I .125 FfE . . 8. FfE 1.0 FTE .5 FTE grades P-6 at CLS and local FfE (local (statute (statute at (local need approx. 150 P-6 at Wa- service need need) at 1:800) at 1: 1,600) He-Lut, total 800 1:1000) students. Service Gao: .125 FTE .6FTE 1.0 .FTE .SFTE
GPRA 2, disciplinary referrals, can be considered a broad indicator of the magnitude of the needs of our students; as their social/emotional needs are met, the number of office referrals will decline. The baseline projection, below, shows a significant need despite existing general education counseling services . . It is based on a fully developed and consistent referral process.
Table 22 GPRA 2: average Number No. of referrals {13-14 SY, extragolated number of disciplinary referrals: Enrolled to end of year
Chief Leschi and WaHeLut Approximately Approximately 350 (prorated: to be grades P-6 800 confirmed at the end of the school year)
Addressing the gags, GPRA 1. & 2: . Personnel gaps. will be filled through both salaried and contracted positions. Expanded partnerships for mental health supports will be established through intentional and explicit outreach, coordination, increased capacity and removal of
Chief Lesch i Schools Elementary School Counseling Proposal, CFDA 84.215E page 2 PR/Award# S215E140513 Page e15 barriers to service access, both in school and in community. The. extent and manner in which we will address our students needs is tied to the pervasive and long standing nature of extensive need for services. Graph 1, below, (Pierce County Health Dept., 2013) shows a high rate of
deaths from all causes for Deaths from all causes, Pierce County, 2011 Native Americans in our .,, 2500 s"' ~ .. 2000 community over other 0 1500 ethnicities. The rate for ~:;; a. .; 1000 ~ Native American males ..,""~ 500 ~; e 0 (center blue bar) is :c .. Ji :r ~ z ~ ~ v z :;;_ ~ "'~ .. "' Q ~c -.g "i profoundly higher than any !! c"' .a ~ ~:;; a £ ~ other ethnicity, and is
predicts increased risk, e.g., family dissolution and poverty. This in tum widens the gap between need and services, including mental health, crisis response, treatment, therapy, and after-care.
The primary focus of all activities of this project is to increase mental health related services that will lead to academic, social and emotional success for all students. For CLS students, however, the barriers and gaps can sometimes seem to be insurmountable. Historically, measures of academic progress for Native American students consistently report chronic
underachievement and CLS is no different in that regard. In spite of academic reforms attempted
under NCLB, we have seen little progress (BIE Annual Reports, www.bie.edu). Based on
Washington State annual assessment data, reading proficiency is consistently below 50% and math below 20%. Measures of student health, connection to school and social-emotional
proficiency are also indicators of low achievement:
• For the recent SY, there were 392 K-12 suspensions/expulsions, 123 for violence
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 3 PR/Award# S215E140513 Page e16 • 167 school days of absence were recorded as a result of chronic lice infestations.
• CPS referrals over the past 4 years have annually increased by approximately 50% per year.
Impacts on school performance are clear. Thus far this year (2013-2014 school year), 151 elementary office discipline referrals have been submitted at CLS elementary school (GPRAl) ..
Another key indicator of need and future success is that of unexcused absence rate. Presently, the unexcused absence rate for CLS is the 3 rct highest among 1,685 districts in Washington State
(Washington State OSPI Report Card). We will track these rates continuously as a key measurse of success, particularly for school environment and safety referrals, e.g., bullying and intimidation. Ensuring a safe learning environment is a project priority.
Entry into kindergarten, and daily transitions present radical variation from the traditional extended family and tribal environments most of our students have known. Our students tend to
be highly mobile, moving between immediate and extended family homes as a result of parental separations, CPS concerns, poverty, incarceration or treatment. The annual mobility rate in our school is approximately 30% per year. Transitions entail moving from unstructured, rule-variable environments to the school environment with its consistent and demanding structure. This.
project will increase the ability of all students to differentiate among settings and develop skills and strategies to adapt effectively. Through intentional efforts to increase connection to school as well as through providing best practice social emotional skill instruction, students can learn to
adjust effectively to transitions and carry the skills with them across environments and over time.
Early interventions and transition support, e.g., from preschool to kindergarten and from 5th grade (elementary) to 6111 (middle school) will be specifically supported by thi s project, e.g., through consultation services and as part of family based supports as described herein .
. While Chief Leschi represents new possibilities for Native American students, it is also
Chief Lesch i Schools Elementary School Counseling Proposal, CFDA 84.215E page 4 PR/Award# S215E140513 Page e17 regarded as "a last chance school". for the highest-risk youth and for young Native people who have been expelled from other public schools, or who are reentering the community from the juvenile justice system .. The most recent survey of Chief Leschi's general student population conducted by the Tri-Ethnic Center for Prevention Research reported that 43% had committed a crime, 31 % had been arrested, 59% had been suspended or kicked out of school, and 27% had failed a year. Clearly the gaps are great. We will address those gaps by measurably increasing the ability of all elementary students to successfully navigate between home/community expectations and develop skills and strategies to of social and emotional competence.
Classroom-based, school-wide initiatives, while essential to student connection and success, are only half of the picture. Historic causes and conditions continue to play out in Native
American homes and communities up to the present moment. Systemic poverty, distrust of the majority culture and habitual responses to distress limit the ability of many CLS parents to access needed physical and mental health services. Chief Leschi School is uniquely positioned to
partner with parents, tribes and community agencies to address these issues. Through intentional collaboration and patient development of relationships we can increase the likelihood that students-and families are willing and able to overcome barriers to services for wellbeing.
Strategy one: (filling service gaps) will be addressed as follows (measures in italics):
1) Create and sustain a coalition of child and family centered providers from tribal and
community serving agencies to guide the project: documentation includes partnership meeting
agendas, minutes, and operational memorandums of agreement.
2) Provide a 1.0 Social Work position to help CLS students and families overcome barriers
to health and wellbeing to assure positive development and learning: hiring documentation and
service logs demonstrate implementation and allocation of resource to project.
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 5 PR/Award# S215E140513 Page e18 3) Provide a .5 Mental Health Professional to initiate and develop a sustaining ability to
provide on-site mental health evaluation and counseling for students .. ..accurate diagnosis and
intervention plans I reports demonstrate increased success in school and home environments
4) Hire a .5 fte school psychologist I behavior interventionist and contract for psychiatric
consultation and clinical psychological services for behavioral plan consultation and neuro-
psychological evaluation: contracting I hiring documentation and resulting evaluation reports,
recommendations, treatment plans, consultation logs, outcome reports, etc.
5) Traditional Healing Activities (contracat), Native American oral tradition "social stories"
and youth mentorship activities will be provided, including culturally grounded approaches to
reclaiming youth, e.g., Medicine Wheel (Brokenleg, 2004): service plans and service logs
6) .5 fte , Community Relations and Military Family Outreach Coordinator will work to
ensure that project services are explicitly extended to our community, particularly the military
families in our community. Military participation is a strong tradition in Indian Country. . This
worker will also maintain coordination of partnership services and outcomes and will therefore
be well positioned to directly facilitate removal of barriers to our family members connected to
extensive nearby military installations (JBLM and Breme1ton Naval installations): partnership
coordinating documents, e.g, meeting minutes & outcomes, military contact logs.
Per above, we will link project staff to a coalition of child and family centered providers from tribal and community serving agencies to guide the project and overcome barriers to health and wellbeing to assure positive development and learning. Psychological I MHP support for
behavioral plan consultation and neuro-psychological evaluation, psychiatric consultation and
neuropsychological consultation is included. These services will provide valuable assessment data for students. in the following domains:. attention and executive functioning, as well as
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 6 PR/Award# S215E140513 Page e19 language, memory and learning. Psychiatric consultation will be valuable in regards to clarifying diagnosis and medication management for the range of childhood disorders and informing mental health treatment referral planning. We will develop a sustained ability to
provide on-site mental health evaluation and counseling for students whose families lack the ability to access community-based MHP services. We will support accurate diagnosis and intervention planning for increasing student success in school and home environments. During the second and third years of the project, following the establishment of a "best practice" model, efforts to identify community-based providers for these services. that are responsive to the cultural and historical circumstances of Native American children and families will be identified and additional funding sought to continue to address barriers. and provide services ..
Strategy two (filling the gaps, programt The classroom is where connection to peers, adults and learning primarily occurs. Positive support of students through compassionate understanding of their needs and skilled management of the learning environment are crucial to the ongoing
willingness of reticent students to risk engagement in learning. To assure that teachers and para- educators develop and maintain these interpersonal and management attributes we will build on
an initial investment in Safe and Civil Schools to hire highly qualified project staff who will, along with guiding the implementation of the Second Step curriculum, train and reinforce
positive and proactive prosocial suppo1ts. A comprehensive school-wide behavior data tracking system that is easily managed and teacher-user friendly (e.g. AIMSweb Behavior, TRENDS) will
be used to provide for data-based decision making at all levels.
For many CLS students, there is little similarity in expectations and adult responses between home and school. Students tend to apply coping strategies learned from their home and community environments at school. It well established from abundant research (casel.org) that
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 7 PR/Award# S215E140513 Page e20 consistent instruction and practice in social and emotional learning (SEL) can, in addition to increasing the. likelihood that students are more. emotionally healthy, increase. academic achievement. Therefore, intentional instruction and reinforcement of SEL for all students by trained educators, via a proven curriculum is an additional strategy of this project.. We. will expand Second Step training and implementation to all elementary teachers as a core curriculum to assure that every student receives consistent instruction in SEL..
2.A Project Design, "extent to which the proposed project will establish linkages ...'': As described in the design elements, above, an overarching aspect of our project is to establish new linkages and bring increased purpose and collaboration to existing providers. Through this, we will address gaps by increasing linkages to. age-appropriate, culturally relevant mental health services that are preventive and comprehensive. These activities will complement existing school and community counseling and promote children's understanding of peer and family relationships, decision making, and positive peer interaction. Increased collaborations will support in-service training for teachers, instructional staff, e.g., training in identification and early intervention techniques. Parental involvement will be explicitly included.
Chief Leschi Schools is uniquely situated to form a strong coalition of youth serving entities through this project. We will build on the cun-ent relationships we have with Tribal Mental
Health Services, Good Samaritan Behavioral Health and local youth and family services to assure that we are all Pulling Together toward physical, mental, spiritual, and emotional healing of Native American youth andfamilies. Youth and families will strengthen identity and wellbeing in the context of traditional ways.
Chief Leschi Elementary has existing elementary counseling in place. However, the nature of our P-6 school population presents a tremendous need for mental health related therapy and
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 8 PR/Award# S215E140513 Page e21 counseling services including on-site MHP capacity (now at zero), social work (now at zero) and
psychiatric consultation (also at zero). New on-site mental health capacity will be linked with increased referral based services - especially community mental health providers:
Table 3: explicit goals for increased linkages to community, parents and providers:
l. By the end of the project period, at least six new or revitalized linkages will be established with community and tribal service providers (mental health related), e.g., through formalized Memorandums of Agreement or contracted services to close gaps in services.
2. By the end of the project period, more than 25 community providers (youth development related) will have participated as volunteers and I or collaborative pa1tners in the successful implementation of the project.
3. At least 600 students, parents and community members will have participated in one or more of the involvement activities including increased parent engagement (school attachment protective factor) and engagement with partners .
In addition to the above measureable goals/objectives, please see GPRA explicit goals, needs section 1, as well as outcome and process measures (evaluation section 4):
2.B Project Design: Addressing needs of target population and other needs: Our design is appropriate to our population of students based on risk data described above. Many students have come to us as a school of choice after failing in other local schools. Many other have come
up from our feeder preschools, e.g., CLS and Grandview ELC (GELC) with extensive developmental needs. CLS preschool is considered part of our elementary school. We partner with GELC through a Memorandum of Agreement as a tribal entity. Our project is designed to
build on the strengths of Native American traditions, increased linkages to the resources of the
Puyallup Ttibe of Indians, Community Health supports, and best practices in the provision of education and school-based mental health to assure success for students of CLS and WaHeLut elementary schools. We recognize that successful transitions are built on all students' developing a sense of belonging, mastery, independence, and efficacy (2002, Brendtro,
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 9 PR/Award# S215E140513 Page e22 Brokenleg, Van Bockern) as well as protective factors that can build resiliency. Intentional teaching practices-including social and emotional education, relationship building and emotional resilience lead to a sense of mastery. We will implement the Check and Connect (see ici.umn.edu/checkandconnect) model to ensure that all students have an enhanced opportunity to connect each morning with a caring adult mentor who will monitor student attendance, well-
being and achievement. Addressing the needs of our students means that project staff will need to spend the majority of their time in direct counseling with students serviced by the program.
Our design has been developed to address: early and persistent antisocial behavior, early academic failure, and lack of commitment to school (per Hawkins I Catalano body of research, see below). Our design features specifically address those needs. For example, teaching staff will be provided planning time to develop student centered projects that develop academic competencies, teach social resistance skills, conflict resolution, and anger management.
Opportunities for adolescent children to interact with positive role models in the community are limited and are not routinely structured. We are convinced that mental health program enhancements will reduce drug abuse, retrieve disheartened dropout students, decrease incidents of violent and aggressive behaviors in the school and community, and increase school attendance and, therefore, the academic success of Native American youth who come from poor, high crime, and violent environments with high rates of alcohol and substance abuse .
. 2.C ... up to date knowledge from research and. effective practice underlies our design.
Research is clear: to be effective, school-based mental health services must be linked to existing organizational structures in the school, coordinated with community-based resources to extend the continuum of care available to address more severe and acute needs, and evaluated based on data. Using a "public health framework," these initiatives would encompass the development of
Chief Leschi Schools Elementary School. Counseling Proposal, CFDA 84.215E page 10 PR/Award# S215E140513 Page e23 multi-layered approaches, interventions, and services that address the continuum of student needs, including primary prevention and education, screening and detection, treatment, follow-up and crisis services, as well as case and systems management as necessary. Our research based framework considers a variety of intervention points for meeting student needs, such as, policies around behavior and discipline, classroom management practices, protocols for refen-als for screening and service provision, the manner in which students receive. an array of supporting services, and efforts to ensure that all approaches and interventions undertaken are coordinated, culturally, linguistically, and developmentally appropriate, and evidence-based.
Methodology and Research Base: The comprehensive approach described above follows the
Hawkins/Catalano. body of research on Risk/Protective factors (Hawkins, Catalano, et. al., 2012).
This provides a methodology in assessing and addressing the magnitude of gaps within the community, family, school, and individual/peer domains. (Risk Focused Prevention).
Community Extreme economic deprivation. Tribal headquarters are located in East
Tacoma-one of the most impoverished and violent sections of the metropolitan area. Sixty-four percent of Chief Leschi students come from Tacoma; the highest poverty rates exist in East
Tacoma's Salishan neighborhood (79%) and the northeast comer of the Hilltop (61 %), neighborhoods in which most Chief Leschi students live. Low neighborhood attachment and community disorganization. The economic conditions in ChiefLeschi's service area are associated with high rates of crime and drug activity-all of which account for the neighborhoods in and near the reservation having a reputation of violent activity
Chief Leschi Students are at high risk of substance abuse. The most recent Tri-Ethnic Center
Survey of our youth reported: 13% of 5th graders were at high risk of substance abuse. Substance abuse rates among our 11th-1th graders are particularly disturbing: 29% reported that they had
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 11 PR/Award# S215E140513 Page e24 been drunk in the last month, and 55% reported they had smoked marijuana in the last month
(nearly twice. the national rate).
Family Family management problems. Frequency of child abuse and neglect is a compelling barometer of family risk factors. Puyallup Tribal Children's Services received 108
CPS referrals for the last school year from CLS elementary. Nearly one out of every eleven children residing on Puyallup Reservation trust lands is under Children's Services supervision.
Rates of child neglect referral are 150% of baseline over the last several years. Family conflict.
Within our 7111 through 1th grade population 18% report that their family fights and argues a lot;.
39% report families with almost no involvement in school activities; and 27% report weak family support of school goals (Tri-Ethnic Center June survey). Number of single parent families. Over
74% of Chief Leschi students come from non-traditional single parent or blended families.
Within Pierce. County the rate of families maintained by female householders. was. 27 .3 % in
Native families compared to 16.5% in the general population (U.S. Census).
School . Persistent antisocial behavior in early adolescence. Four measures of antisocial behavior are (1) rates of discipline referrals, (2) gang involvement, (3) school violence, and (4) guns in school. Gang involvement is high and usually begins in 4th and 5th grade. Some of our families are third generation gang members. Academic failure. Delinquency and dropping out of school are related to. academic failure. At Chief Leschi, standardized achievement test scores indicate that many students are failing to have academic success. Although the scores have generally increased over the. last three. years in each subject area for most grade levels, Chief
Leschi students, overall, still have lower than average scores in math, language and reading.
Lack of commitment to school. Two indicators for lack of academic. commitment are absences from school and dropout rates. Dropout rates are more than twice the non-Indian average.
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 12 PR/Award# S215E140513 Page e25 IndividuaJ/Peer Favorable attitudes toward the problem behavior/Friends who engage in the problem behavior. The Tri-Ethnic Center survey of ih-12'b graders reported that 43% of our students have friends who encourage them to get drunk, and 56% have friends who encourage them to use marijuana. Further, 60% have friends who have failed a year; 77% have friends who were suspended or kicked out of school, and 47% have friends who have dropped out of school.
Early initiation of the problem behavior. Chief Leschi students engage in substance abuse and gang behavior at an early age. Among Chief Leschi students the average age of first drunk was
13.5 years, and the average age of first use of marijuana was 12.8 years (Tri-Ethnic Center
December 1999 survey). Alienation. High rates of suicide among our youth indicate high levels of anomie. According to a recent state Youth Risk Survey, disproportionate numbers of students seriously considered suicide. Recently, one of our HS students took her life.
ACES research has identified a scale of eight adverse childhood experiences (ACES), which are predictive of poor physical and mental health outcomes. ACES are stressful or traumatic events during childhood that include: physical abuse, sexual abuse, verbal abuse, mental illness of a household member, substance abuse use by a household member, divorce or separation of a
parent, domestic violence towards a parent, and incarceration of a household member.
Table 4: Adverse Childhood Experiences
• A third of respondents in an ACES survey of our service area (on and near the reservation) reported one or two ACES and an additional third reported three or more ACES.
•Native American families are disproportionately affected. For example, the CLS abuse and neglect rates reported by CLS staff have increased to 150% of the prior year over the past four years. The CLS "catchment area" has 12. l % of the state population, yet receives. 20.4% of total prison releases (2005 report by the Washington Association of Sheriffs and Police Chiefs).
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 13 PR/Award# S215E140513 Page e26 Effective practice will be based in a team approach that fits seamlessly with our existing comprehensive approach in addressing the counseling and educational needs. of our students .. We have fully established Positive Behavioral supports system already in place that is built on Safe and Civil Schools .. In addition to that, this project will integrate well with a fully developed academic and behavioral response to intervention system (RTI). Universal screening is used to determine academic and behavioral needs for all students. Benchmark assessments, progress monitoring, targeted interventions, and the use of proven curriculum helps ensure that severe acting out is not the product of students chronically being on "frustration level". Also, the
behavioral response to intervention program utilizes a "care team" approach that provides infrastructure for early behavioral supports and school based counseling to respond to. the daily social/emotional needs of our students. Therefore, the system of mental health supports described here will be carefully integrated into a well-developed foundation that uses a developmental, preventive approach. New services under this proposal will increase the availability, quantity, and quality of counseling and therapeutic responses. Those. services will be provided by our current high quality counseling program in cooperation with the new school
psychology, social work, MHP services and new availability of child psychiatric care. .
These services will be provided through an innovative culturally relevant approach that increases our students' engagement in positive peer, family, and community relationships .. This will lead to improved self-understanding and effective social problem solving. The deep cultural context of our tribal schools provides safe spaces for personal discovery and growth. However, traumatic events, unsafe home environments, and other risk factors, including increasing levels of child neglect require the additional therapeutic services and linkages in this project design.
Services will be provided both in school and clinical settings as determined through a well-
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 14 PR/Award# S215E140513 Page e27 designed referral process. that is integrated with existing practices and that directly engages mental health partnership providers. Memorandums of Agreement have already been established with both Good Samaritan Behavioral Health and Kwawachee (tribal} Mental Health agencies. Those MOA's will be updated to explicitly describe the improved collaborations under this project. For example, implementation of curriculum based procedures,. e.g., Check and
Connect and Second Step, will be built on sustained professional development for effective implementation. The MOAs will describe how CLS staff, project staff, and agency staff will link together to provide not only training in how to use the curricula, but how sustained "behavioral intervention coaching" can build the capacity of teachers, paraeducators,. and support staff to make decisions in "real time" with struggling students to reduce bullying and harassment and replace those behaviors with positives. Despite efforts of adults to reduce bullying or other forms of violence, staff cannot always catch instances. Even one bullying event is not acceptable. The preventive approach described herein will be balanced with an increased level of surveillance through the use of cameras throughout the school with appropriate follow-up.
We will intentionally involve parents of participating students in more effective parenting.
Not just through classes, e.g., provision of"Positive Indian Parenting'', but also through ongoing consultation and guidance provided in safe and confidential ways. This intentional and comprehensive team approach will ensure that the project staff will spend a majority of their time in therapy and counseling with students and related activities directly related to the counseling process, e.g, promoting parental engagement.
3) Quality of Management Plan (A) Adequacy ... to achieve objectives on time and within budget... Tables. 5 & 6 identify responsibilities, timelines, and milestone strategic tasks that are linked to objectives.
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 15 PR/Award# S215E140513 Page e28 Table 5: Impact Objectives: . At the end of three years of project operation:. 1. Services: Increased counseling/ mental health fte's available to CLS students. will have. increased by 2.0 fte's with additional support through contracted and referral services. 2. Behavior: An aggregate reduction of 10% from baseline will be demonstrated in the number of students referred for disciplinary actions including. acts. of violence, or use of drugs/alcohol, as measured by incident reports . . 3. Survey outcomes: For individuals regularly participating in the center, 80% of ethnographic interviews and surveys will indicate that stakeholders report project activities to be helpful, of high quality, and of assistance in improved learning . .
Table 6 describes methods to achieve. project objectives on time and within budget..
Table 6 Management Objectives: Enhance and increase school based mental health services that: 1) focuses management activities; 2) ensures equitable access and financial efficacy; 3) supports attainment of project timelines and deliverables; 4) promotes sustainability. Project Activitl'. Who? When/ To what evaluation where? Puruose? measure Project Director (existing Chief Leschi By week Initiate tPersonnel files personnel) hires project staff:. Personnel 3 grant document hiring Project Coordinator hii:ed, then Office activities of high qual~ty participates in other hirings. staff. Project coordinator All students and By week .Enroll iJ)ocuments communicates an intake their families K- 4: students in compiled by ,System that establishes 5 are eligible: conduct program coordinator w/ caseload needs and delivery of High risk factor outreach activities, counseling & project activities for all walk- student outreach m Assess project staff.
ins and referrals in project: conducte
developed for highest needs 1!PT for services determined data and students & families: link to implementatio-9. inititated, by inta1$.e discipline .report social services: e.g., Tak:opid ofi plans as oase data process, data included in Health Authority, Good Sam managers. sfstem above.) reports ..
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 16 PR/Award# S215E140513 Page e29 Hospital, treatment center, etc. Recruit and train community Community Organize Effacient Project members to activeI y 'Liaison BLT Recruit- use of Coordinator participate in all projecti partners,. tribal ing& resources;. summarizes. activities, e.g., mentors, tutors, and community training project outcomes in elder involvement, activity resources atJeast continua- monthly reports: volunteers, partn,ership participate quarterly tion after forwards to personnel including Tribal training grant end Project Director
Kwatchee, Good Sam1 etc. and BLT Project activities reviewed to 1Project At least Address Curriculum based Coordinato , youth determine adoptions. of I quarterly assessment and prosocial prevention based PCC, Principal individual di:cipline curriculum is included. approval risk factOFs reported quarter~y Collect program outcome data Project mngr & Data Design Annual data and disseminate and analyze staff, grants collected project analysis reports an annual "participant coordinator per i mprove- compiled by satisfaction survey" and survey mei;its & project director student risk factor survey, e.g., I dates evaluation tri-ethnic survey -- Incorporate key activities of Coordinator in By week Reduce Monthly the after-school project.into cooperation 1 of next affer-school afterschool activities, e.g., friendship wjth Principal: after risk factors program circles, and cultural activities target latch-key school improve summaries sl;low into preventi9n programming students. program attachment student participation A menu of community project Principals, Activitie Jnvo1vemen Written plan, & in vol vemeur activi ties project mngr., s start by t of parents calendars & designed, e.g., program staff meutal health week 8 with their events published participate in quarterly "(am,ily providers children and dissemil ated nights" Conduct periodic student and Specialists, By 3 rd Address Written plan, & family mental health offerings csmnselors, month health periodic ~g . conflict resolution, healthy Takopid Health needs calendars lifestyles center published A summer and seasonal event Project., Planned lncrease Written plan, activity pl~n is developed that coordinator, by June protectiive calendars and includes project staff and specialists, 30 each factors brochures partnership resources, access Tr" bal Partners, project during times published and to couQ.seling, parent support community year. of less disseminated, and cultural programs such as partnerships structure in student those included in objectives student's participation one and fwo. Sumrnei: lives. documented activities. may be hosted by 11 partners
Family and community - Project staff, At least 3 Increase Wrjtten plan,
Chief Lesch i Schools Elementary School Counseling Proposal, CFDA 84.215E page 17 PR/Award# S21 5E1 40513 Page e30 involvement" events planned school - I year community calendars. and with cultural themes, e.g., person,nel, attachmeQ.t brochures eveI).Js hono;i.I).g elders partners - -- published -
(3B) Adequacy for ensuring feedback and continuous improvement in operations. (also see
"evaluation, section 5) Our project design includes opportunities for our community to participate in project management, e.g., Partnership Coordinating Committee (PCC) and Building
Leadership Teams (BLT)). Activities such as periodic "parent nights" will be a focal point for dissemination of project information to the community, and for solicitation of feedback regarding program effectiveness. A diversity of perspectives has already contributed directly to the design of this proposal through Tribal Partnership Group involvement (teacher, student, administrators, parents); through BLT consultation, e.g., with Kwawachee Mental Health, and through building level involvement (community and parents). The Partnership Group will be invited to participate in the ongoing review and design of the project through PCC activites. These partners and constituencies will continue to participate in the operation of our proposed project to promote sustainability after federal funds cease. The BLT will receive a monthly update on project operations and outcomes, and will make recommendations and identify resources in cooperation with the project coordinator. The BLT will formally review the operation of the project, and the expected impact on test scores and other key student outcomes, such as reduction in drug/alcohol related risk factors. Periodic performance and financial updates for the project will be made by the Chief Leschi School Superintendent to the Chief Leschi School Board.
Feedback and continuous improvement will be provided by the Building Leadership Team.
Tribal Partnership Groups will provide grassroots advice on a monthly basis. The Project
Coordinator is responsible to work closely with Building Principals and the Building Leadership
Team to synthesize the feedback from these sources with the data generated through evaluation
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 18 PR/Award# S215E140513 Page e31 measures. This combined information will be utilized to focus resources in those activities and services that most effectively contribute to achievement of project objectives. Program staff will work closely with the building principals and PCC to continuously monitor and modify the deli very of services within grant guidelines for best results. The project director will support these efforts through coordinating project personnel and resources .. The project director will meet with the elementary Tribal Partnership Group at least quarterly to ensure that services are effectively and efficiently integrated with daily operations .. For example, if teachers at the elementary are all teaching a thematic unit based on intergenerational post-contact trauma, school based counselors would carefully reach out to students affected by those issues. If a suicide were to occur despite the prevention efforts to reduce those occunences, mental health providers would coordinate services on-site to target supports to the high number of students with grief and loss issues. These meetings will be an opportunity to exchange information about project outcomes.
The project coordinator will obtain data and reports on how the project is impacting key indicators such as student attendance, behavior, and academic achievement. The project coordinator will work to coordinate the activities and service provision within the schools.
Figure2: Project Functional Relationships Design (grant funded positions shown in bold)
Project Director I Data Management: principal time (in data to director and kind) responsible for external evaluator in advance of PCC overall leadership meetings. and deliverables.
Professional Staff, e.g, Outreach MHP, MSW, Coordinator: PCC I Psych. Partnernship Coordinator Development & Linkages da ily operation
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 19 PR/Award# S215E140513 Page e32 . The. above graphic shows how project staff will work with an oversight team that includes key
partners, e.g., school, parent, tribal, community health, juvenile justice and other youth serving organizations to guide the. implementation, monitoring and evaluation of the project. Contracts or MOAs will be established with mental health service providers. In addition to the identified at-risk data mentioned above, the following pre-post evaluation measures will be used:. The
Behavior and Emotional Screening System(BESS) and Tri-Ethnic Survey (Colorado State
University). Timelines. include:. Implement Check and Connect strategy for all elementary students (December 2014), Initiate training and implementation of the Second Step program in grades k-3 (January 2105), Build on past training in Safe and Civil Schools to include new teachers and para-educators (summer 2015), Begin on-site contracted services for individual and small group mental health counseling (January 2015). Begin contracted mental health consultation and evaluation (February 2015).
( 4) Quality of the project evaluation: (A) ... use of objective performance measures ...re lated to intended outcomes ...qua litative and quantitative data ... . Our design sets out goals and objectives for measuring project deliverables .. A strong annual evaluation plan will form the basis for documenting progress toward those outcomes. We have defined
performance targets that determine. when satisfactory progress has occurred. Therefore both formative and summative data will contribute to a thorough evaluation based on expected goals, objectives and outcomes. The evaluation procedures are integrated into the daily practice of operations to ensure feasibility and efficiency. The management plan clarifies responsibilities for data collection, "roll-up", and reporting. The evaluation of the goals and all related project activities, particularly as they relate to the two GPRA criteria, will be referenced to indicators as
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 20 PR/Award# S215E140513 Page e33 described in this and previous sections . . Internal process and outcome data collection will be referenced to the GPRAs 1&2 as follows:
GPRA 1: We will close the gap between the CLS. student/mental health professional ratios. and the student/mental health professional ratios recommended by the statute by a total of 2.25
The number of mental health professionals working in the school will be documented through
personnel records and through organizational charts for before and after implementation of the
project. Additionally, detailed schedules, service logs and/or time and effort documentation for each provider will document the specific added capacity to daily operations, particularly for student interventions and supports. Contact logs will be maintained to document "leveraging" of resources, e.g., through community (and parent) contacts and referrals. Existing digital infrastructure and networked communications tools will be used to efficiently collect, maintain and access these data. Data will reflect increases in access to community-based and tribal mental
health resources for students and families as measured by successful referrals to service, outcome documentation, and generalization of new skills to school settings, e.g., through after-care support frequency counts and service logs, and measureably reduced disciplinary referrals -
GPRA 2 goal: CLS will demonstrate an annual reduction over baseline of at least 10% per year in the average number of referrals for disciplinary reasons, given consistent referral procedures.
Objectives have been closely integrated with existing reforms to promote successful project
"start-up" and improved efficiency and effectiveness. Goals and objectives are consistent with our mission as a community school and are therefore integrated with school-wide performance measures. Evaluation is linked to highly visible overall annual measurable objectives and performance measures (table 5) which define the types of data to be collected and reported.
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 21 PR/Award#. S215E140513 Page e34 Project process and outcome data sets. will be referenced to state and department of education
performance requirements. Progress monitoring data is to be collected monthly and "rolled up" to the project director. . The project director will share outcomes with stakeholders (PCC) and school administration in weekly "administrative round tables". Core outcome data will be formally collected, analyzed, and shared at least three. times per year.
GPRA 2 indicators: daily data for disciplinary referrals will be reported in the school's student data system (Infinite Campus). Ad hoc reports from this system will include formative data of improvement over baseline for reductions in discipline referrals. Quantitative and qualitative data regarding the category of each refen-al will be collected and reported, e.g., counts for categorical data as well as severity of the infraction. For example, not only will aggressive
behaviors be reported, but the nature of the behavior will be detailed, e.g., bullying or harassment. Data will include not just disciplinary action, but also the corrective intervention, e.g., referral to counseling or assessment for mental health supports. We will utilize timely and high-quality data to improve the practices that help all students to successfully navigate home, school, and community expectations by developing social and emotional competency:
Table 62 Process objectives and data driven decisions include:
1) Institute a Check and Connect strategy: Data will include attendance and participation in a daily home-room that includes the check and connect process as describe in the project design section. Individual positive behavior plans will create data driven decisions.for high-needs students (as determined through analysis of daily disciplinary data). 21 Increase instruction and reinforcement of social and emotional learning (SEL1: Trained educators including new mental health providers will implement a proven curriculum (Second Step) that will Renerate curriculum based evaluation data and analysis. 31 Provide teachers and 12ara-educators with the training and su1212ort to provide positive and proactive classroom management that increase connection to school and learning. Safe and Civil schools data e.g. structured observations of the ratio of positive to negative interaction ratios will be collected in school settings . and shared with instructors & admin. End of year Fall Activities I Winter Activities I Outcome Activities Indicator (link to data type, collection procedures, methodology and instruments, analysis and reporting of results. for accountability and replication)
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 22 PR/Award# S215E140513 Page e35 Increased BLT (advisory group) Annual outcomes access to Establish and analyze analyzes quarterly on-site for student services. school based on-site student services student services data, counts is reported mental health baseline data, placement and referral based on internal and links to placement and refetnl counts to mental health and external data community counts to mental health services per referrals, sources to services referrals. intervention & after care. stakeholder group (Quantitative) Improvements Establish baseline. for Measure and report data Formal review and in learning and NASIS disciplinary including classroom and reporting of all data school data and counselor I therapeutic data re: social sources and adjustment provider caseloads and skill progress toward published executive (Qualitative and individual plans .. behavior plan target summary of annual Quantitative) behaviors, e.g., on-task progress. rates, and social curriculum based data Disciplinary Determine initial rates Track referral rates for Analyse rates. per referral Rate per BIE (state) leading indicators, e.g., management plan (Quantitative) definitions of student behavioral referrals, and and expected infractions following indicators, e.g., outcomes. attendance data. Student Establish 1st Semester Refine 2nd Semester Determine annual outcomes per caseloads, refine caseloads participation e.g., behavior plans through school year. attendance, (Quantitative) retention,. plans. data
In addition to the parent summative performance data, qualitative data will be obtained through the quarterly perfo1mance reports generated internally by the project director.. Data will
be collected regarding implementation status and quarterly tracking of participant data. These data will be. shared with the administration and the PCC as well as. the evaluator.
(B) The extent to which the methods of evaluation will provide performance feedback ... :
The tables above, taken together, will provide formative and summative data to stakeholders and management with a clear means of determining project effectiveness. The project design includes opportunities for our community to participate in project evaluation results, e.g.. annual community report and through ethnographic interviews. The parent nights will be a focal point for dissemination of project information to the community, and for solicitation of feedback. A
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 23 PR/Award# S215E140513 Page e36 diversity of perspectives has already contributed directly to the design of our project through
BLT I and tribal connections. Our leadership has participated in the development of this evaluation plan, and understands that the effective use of data for monitoring individual
perfo1mance and service delivery is essential to student success and will monitor program implementation for necessary adjustments. Sharing data with stakeholders is crucial in achieving the "buy-in" necessary for parental and community involvement, as well as program sustainability. These practices have created a culture of accountability for results. A strong evaluation design, coupled with clear management responsibilities will lead to success.
Internal evaluation: tables above include quantitative and qualitative performance measures.
The project staff will work with parents and teachers to establish individual plans for the highest needs students (repeated disciplinary referrals) that will yield outcome data, reported in aggregate form. Evaluation objectivity will be provided through internal management controls, and through the evaluation and governance function of the. Project Director, principals, BLT .. It will be the responsibility of the Project Director to collect outcome data, pa1ticularly for GPRA.
External evaluation: The external evaluation will include three data sets . . The first data set includes review of quantifiable data, e.g., school attendance, disciplinary data, and parental
participation rates. Baseline data from the fall of the school year (prior to program enhancements) will be compared with outcome data (in June). The second data set will be based upon a battery of ethnographic surveys. of risk factor related variables. among students .. The contracted outside evaluator will conduct periodic interviews with school administration, teaching staff, stakeholders and parents. Two sets of interviews. will be. conducted annually. The first interview will be completed as near as possible prior to implementing the proposed enhancements during the initiation of the project. Instructions to. the staff for administration of
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 24 PR/Award# S215E140513 Page e37 the surveys will be provided by the external evaluator. A complete report of the survey results, by grade, will be provided after each administration .. The. third set of data will include records. of
project implementation success. On-site visits will be made by the evaluator for the purpose of collecting and analyzing program and internally generated data. All outcome and process data will be incorporated into annual reporting conducted internally and by the external evaluator.
Annual reporting will be. formally presented to the school superintendent and other stakeholders . .
The BLT and PCC (advisory I data review group) will include discussion of project activities on their periodic agendas. Each school's. student councils will be invited to participate in the ongoing review and design of the project. Partners and constituencies will continue to
participate in the operation of our proposed project.. Principals will receive. a monthly update on
project operations and outcomes, and will make recommendations and identify resources in cooperation with the. project coordinator. Perfo1mance and financial updates for the project will be made by the CLS Superintendent to the School Board and parents. The Project Director, in will formally report the operation of the. project monthly against goals, objectives and outcomes, and impact on test scores and key student outcomes, such as disciplinary referral reduction rates.
This will comprise a "gap analysis" and lead to. specific recommendations. for "mid-course" corrections. The Project Director will complete a quarterly summary documenting project activities. and progress. Reports will describe successes, note deficiencies, and problem-solving
methods used to resolve them. Data will roll up to annual granter reporting requirements.
We expect that not only will our three year outcomes for this project exceed expectations, but that our stakeholders will report that they are gratified about students' confidence, competence and connectedness. We are confident that long-term positive student and family outcomes will result. from our ambitious and comprehensive approach.
Chief Leschi Schools Elementary School Counseling Proposal, CFDA 84.215E page 25 PR/Award# S215E140513 Page e38 Other Attachment File(s)
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PR/Award# S215E140513 Page e39
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 TABLE OF CONTENTS, CHIEF LESCH PARTNERSHIP ESSC PROPOSAL
Submitted 4-28-14
ABSTRACT ...... one page
NARRATIVE SECTION:
1) Need for Project - Pagel
2) Quality ofthe Project Design - Page 8
3) Quality ofthe Management Plan - Page LS
4) Quality. of the Project Evaluation - Page 120
APPENDICES:
See attachments, including examples of project staff (Vitae)
PR/Award# S215E140513 Page e40 Resume: Norm Dorpat, Proposed Project Director (in-kind, no grant funds, 10% effort)
PR/Award# S215E140513 Page e41 VITAE: Nonnan Domat
Education: Oregon School of Professional Psychology Doctoral work: Eastern Washington University B.A., Education, July 1982: Eastern Washington University M.S., Child Development, August 1979: University of Washington B.S., Psychology, June 1977:
Certifications: Continuing staff certificate, School Psychologist Teacher certification: primary and secondary level
Experience: 1984 to present, ChiefLeschi Schools.a... Special Services Director, Preschool (FACE) Director, classroom teacher, Vocational Director, Director of Development and Planning, Grants Manager, School Psychologist, Special Education Coordinator.
1989-1992: Director of Education, Northwest Indian College at Puyallup Tribe: develop resources, programs, facilities,
1982-1984: Consultant Developmental Psychologist, Special Education Director, Colville Tribal (Paschal Sherman) Schools: special, vocational and gifted education.
1981-1982: Consultant Psychologist, Lakewood Village: Behavioral Programs and evaluations for Developmentally Disabled.
1979-1981: School Psychologist, Bonner County Public Schools, Idaho.
Other Highlights:
• Former Education Director for Northwest Indian College and Development Consultant for Medicine Creek tribal college
• Obtained funding, developed and managed model intergenerational community based adult I early childhood literacy program (FACE).
• Board member: Pierce County Family Development Council.
• Developed model transitional vocational education programs for disabled youth and young adults in cooperation with state D.V.R.
PR/Award# S215E140513 Page e42 • Past President, E.W.U. chapter, Council for Exceptional Children
• Adjunct Faculty member: University of Idaho, Heritage College, Western Washington University, Northwest Indian College: upper and lower division computer education, child development, and counseling· courses.
• Wrote and implemented computer education comprehensive plans for two school systems.
• Coordinated development of nine intra-tribal collaborative agreements for social, health, and educational services.
• Certified ROPES trainer.
• Total group orientation trainer: Goodwill games volunteers.
• Honorable Discharge, U.S.A.F., Sergeant, 1971-1975.
Professional Activities I Organizations (past and present):
• Council for Exceptional Children (past president oflocal CEC chapter).
• CEC, Division for Early Childhood
• National Association of School Psychologists
• National Indian Education Association (associate)
• International Reading Association
• Have authored successful educational proposals resulting in over $6 million in discretionary funding from federal, state, and foundation resources. Over 90% success rate in funding decisions for federal CFDA titles.
• Childhood risk factor prevention articles published in various journals.
PR/Award# S215E140513 Page e43 Resume: Behavioral Response to Intervention Specialist (pending CLS internal H.R. procedures) ... This individual had been previously employed at CLS in a similar position ... but since this resume was developed had retired (therefore no "supplement not supplant"
PR/Award# S215E140513 Page e44 Resume
Stephen R. Burkhart
Specialties: Program development and supervision; behavior assessment and intervention; teaching in special and regular education·elementary through secondary levels; master's level instruction; mediation and facilitation
Experience: Chief Leschi Schools 2008-present Behavior Intervention Specialist: K-12 RTI, individual student and classroom behavior plan development and intervention Kent School District (I year) Academic Coordinator, Performance Learning Center: Implemented High School Performance Learning Center model in Kent Scbool District
City University (3 years) Instructor: Educational Guidance and Counseling and Educational Leadership Masters Degree programs
Peninsula School District (22 years) Teacher: Special Education, Leadership, Social Studies, Science, Conflict Resolution, English, Math and Alternative Education
School Counselor: Elementary and Middle School levels
Program Developer, Manager, Counselor and Teacher: Peninsula SEAL program for emotionally and behaviorally disabled adolescents;
District Level Supervisor: Supervisor of Counseling, Psychology, Nursing, Student Risk, Family Support and Special Education Programs; Grant Development and Management Key Peninsula Family Services start-up
University Place School District (7 years) Teacher: Primary through Intennediate; Regular, Challenge and Special Education
American Samoa Department of Education (2 years) Program Developer, Teacher Trainer and Acting Director: Established new services for early childhood and severely disabled children; trained Samoan teachers to continue services Grant Writer and Manager: Funded education programs with pass through and competitive grant applications
PR/Award# S215E140513 Page e45 Conflict Resolution Research and ResoW'Ce Institute; now The Lincoln Institute (intermittent from 1995 to present) Board member, Vice-President and Conflict Resolution Trainer: Washington State, Russia and Sudan
Education: Washington State Principal Certification City University ((6/2007) M.Ed. in Counseling: University of Puget Sound (1986) M.Ed. in Special Education: University of Washington (1975) Montessori Diploma (1972) St. Nicholas Training Centre BA in Education: University of Puget Sound (1970)
Extensive In-service Training: In many areas relating to special education, teaching, oouns.eling, personal growth, mediation and conflict resolution
Presentations: Numerous presentations for and about youth regarding: children at risk, parenting, conflict resolution, negotiation and family support
References: Norm Dorpat Special Services Director Chief Leschi Schools 5625 5200 St E Puyallup, WA 98371
Richard Basnaw Director of Curriculum and Instruction Chief Leschi Schools 5625 52nc1 St E Puyallup, WA 98371
Bill Wyant Principal Chief Leschi Schools 5625 52nd St E Puyallup, WA 98371
Contact Information: Steve Burkhart 6617 Rosedale St. NW Gig Harbor, WA 98335 253-851-7855 (h) 253-312-2161 (C)
PR/Award# S215E 140513 Page e46 Resume: Consulting clinical psychologist (pending CLS internal H.R. procedures) ...
PR/Award# S215E140513 Page e47 CURRICULUM VITAE ALLEN.R. ALBERTSON, PSYD.
) c
EDUCATION
PACIFIC UNIVERSITY - TIIE SCHOOL OF PROFESSIONAL PSYCHOLOGY Doctor ofPsychology - 2000 Forest Grove, Oregon
PACIFIC LUTHERAN UNIVERSITY Master ofArts-1974 Tacoma, Washington
PACIFIC LUTIIBRAN UNIVERSITY Bachelor ofArts -Psychology-1970
INTERNSIDP
APA - accredited pre-doctoral clinical internship at Primary Children's Medical Center, 1998-99, Salt Lake City, Utah
• Provided psychotherapy, assessment and consultation to children and adolescents at out-patient psychiatry clinic • Provided individual psychological assessments, individual therapy, group therapy, and family therapy to in-patient adolescents • Provided neuropsychological evaluation for children and adolescents referred to Primary Children's Medical Center, Salt Lake City, Utah
SUPERVISED CLINICAL PRACTICUM
PACIFIC UNIVERSITY - THE SCHOOL OF PROFESSIONAL PSYCHOLOGY Practicum - Psychological Service Center -1994-95 Portland, Oregon
• Provided psychotherapy, assessment and consultation to clients at this out-patient clinic • Psychotherapy included adults, children and family therapy with cognitive-behavioral orientation • Responsible for case conceptualization, development of comprehensive treatment plan and DSM-IV diagnosis
PR/Award# S215E140513 1 Page e48 • Assessments included intelligence, personality, neuropsychological, adaptive, achievement and vocational
Supervisor: Dr. Daniel McKitrick
PACIFIC UNIVERSITY - THE SCHOOL OF PROFESSIONAL PSYCHOLOGY Practicum - Pacific Lutheran University Counseling and Testing Center - 1993-94 Tacoma, Washington
• Provided psychotherapy with individual and groups for college students seeking emotional, social, academic and vocational support • Completed psycho-diagnostic assessments of students referred for suspected learning disabilities • Co-facilitated a group for students with non-traditional sexual orientations
Supervisor: Dr. Gary Minetti
PROFESSIONAL EXPERIENCE
TACOMA SCHOOL DISTRICT School Psychologist - 2004 - Present
• Participates as a team member with responsibility for the identification, eligibility, and placement of special needs students. • Participates with other staff to cooperatively plan, develop, and implement a course of instruction designed to achieve required academic essential learnings for special needs students in all curriculum areas. • Participates in child guidance discussions to plan appropriate programs for at risk students. • Participates in team and individual instructional planning. • Facilitates and participates in staff meetings, planning events, department/special education meetings, manifestation determination review (MDR), Functional Behavior Assessment/Behavior Intervention Plan (FBAIBIP) meetings, and eligibility, evaluation, and placement meetings. • Works cooperative!y with total building staff in an atmosphere of cooperation and collegiality.
PRIVATE PRACTICE Consulting School Psychologist - 2000 - Present
• Complete Independent Educational Evaluations (IEE's) for local school districts requesting assessments for students regarding cognitive, achievement, adaptive, social/emotional evaluations, along with comprehensive evaluations of students diagnosed with Autism Disorder and Asperger's Disorder.
PR/Award# S215E140513 2 Page e49 • Complete Risk and Violence assessments for local school districts on youth who have threatened or carried out acts of aggression and violence. These assessments provide school districts with a fonnulation of dangerousness and the development of an intervention plan.
UNNERSITY PLACE SCHOOL DISTRICT Psychologist/Director ofSpecial Programs and Services - 1992 - 2004
• Direct management and supervision of all special education staff and programs, including office support staff, psychologists, occupational therapists, physical therapists, nurses, and vision specialists. • Write and submit federal and state grants • Direct management of all special education programs, including Title I and Learning Assistance Programs (LAP's), home/hospital programs, English as a Second Language (ESL), and health services (nurses) • Responsible for implementing special policies adopted by the Board, including compliance with all state and federal regulations related to special education services for children from preschool age to age 21 years • Providing ongoing staff in-service training for all special education professionals regarding updates and changes related to special education rules and regulations • Direct, manage and evaluate staff for health services (nursing), home hospital, ESL, and special education programs • Develop and monitor budgets for all assigned federal and state grants and programs • Oversee the maintenance of confidential student records required by specific grants and programs • Contribute meaningfully and positively to the administrative management team, and participate in the achievement of the organization's strategic plan • Assure staff understanding and commitment to organization's strategic plan and department mission statement • Managed budgets in excess of 4 million dollars, including projections for upcoming year, budget revisions and end of the year reports • Manage human resources to achieve the highest levels of performance by retaining and attracting the most competent employees (Nurses, Psychologists, Occupational Therapists, Speech and Language Pathologists, Vision Specialists) • Develop a positive, supportive, and collaborative working relationship with students, staff, parents and community • Demonstrate the ability to gather and communicate research-based practices relevant to department outcomes, which can be benchmarked regionally and nationally
Supervisor: Karen Vescovi
PR/Award# S215E140513 3 Page eSO ROCKY BAY HEALTH CARE FACILITY Psychological Consultant - 2002 - Present
• Provide consultation to staff who provide supervision and treatment programs for developmentally disabled adults with psychiatric disorders. • Psycho-diagnostic assessments include cognitive, academic, self-help, personality, adaptive, and vocational/work evaluations as a member of interdisciplinary team. • Complete Functional Behavior Assessments· (FBA's) of clients that lead to Positive Behavior Support Plans (PBSP's) to reduce physical aggression, verbal aggression, and self injurious behaviors in clients with developmental delays and psychiatric disorders.
UNIVERSITY PLACE SCHOOL DISTRICT School Psychologist - 1979-1992
• Completed psycho-diagnostic evaluations of students preschool through age 21 suspected of a wide range of disabilities • Served as a multidisciplinary team (MDT) leader in coordinating comprehensive assessments with other disciplines • Consulted with the multidisciplinary team members including parents, in formulating individualized educational plans based upon assessment data • Consulted with staff, parents and administrators in designing programs and services for emotionally disturbed students • Supervision and training of school psychologist interns
Supervisor: Dr. Rich Knuth
PIERCE COUNTY Guardian Ad Litem/Parent Investigator - 1984 - Present
• Complete child custody evaluations as assigned by County Panel • Conduct comprehensive clinical interviews, synthesizing the data into comprehensive written reports to the court • Guardian Ad Litem must detennine the parenting potential of adults while representing the best interests of children
PRIVATE PRACTICE Psychotherapist for Agoraphobic Treatment Group - 1980-1982
• Received extensive two week training from Dr. Hardy, psychiatrist, Menlo Park, California, regarding treatment techniques with agoraphobic clients • Psychotherapy focused on cognitive behavioral training including desensitization and relaxation training
PR/Award # S215E14051 3 4 Page e51 Supervisor: Dr. Gerald Rosen, Clinical Psychologist, Seattle, Washington
PURDY TREATMENf CENTER Correctional Psychologist - 1974-1979
• Responsible for psycho-diagnostic evaluations of adult female felons under the supervision of a licensed PhD. Clinical Psychologist • Administered intellectual, personality, and projective instruments to this group of incarcerated felons, including the WAIS and MMPI • Served as a consultant for correctional staff providing training and empirically based treatment recommendations applicable to incarcerated female felons • Served as psychotherapist focusing on individuals, group and family/child psychotherapeutic interventions
Supervisor: Dr. Ken Fisher
PIERCE COUNTY Mental Health Professiona.l-1977-1979
• Served as an on-call county mental health professional involving specialized mental health evaluations assessing psychiatrically indigent individuals for detention and hospitalization under the Civil Commitment Act • Required considerable crisis intervention skill and expert testimony for those individuals detained and found to be a danger to self, others, or gravely disabled a~ a result of a mental disorder'
Supervisor: Norm Fournier, MSW
PACIFIC LUTHERAN UNNERSTIY, TACOMA, WASHINGTON Supervised Internship, Counseling and Testing Center, 1970-1971
• One year of supervised experience as a graduate assistant in the counseling and testing center at Pacific Lutheran University • Provided psychotherapy with individual and groups of students seeking emotional/social/academic and vocational support • Responsible for teaching one section of an introductory psychology class
Supervisor: Dr. Adachi
PURDY CORRECTIONAL CENTER FOR WOMEN, GIG HARBOR, WASHINGTON
PR/Award# S215E140513 5 Page e52 Resident Life Supervisor, 1971-73
• Supervisor of the residential treaunent milieu of the work/training release program for adult female felons • Provided individual, family, and group psychotherapy to adult female felons
Supervisor: Essey Wolfrom, MSW
FORENSIC PSYCHOLOGY
• Complete risk and violence assessments for local school districts on youth who have threatened or carried acts of aggression and violence. • Testified orally and in written form to Parole Board regarding prediction of inmate dangers and potential for recidivism • Completed psychological evaluations of adult female felons incarcerated at Purdy Corrections Center • Served as consultant to multidisciplinary treatment team regarding diagnosis and treatment plan formulation with in.mate population • Completed training as Guardian Ad Litem and assigned by Pierce County Panel to complete child custody evaluations • Court testimony as expert witness in terms of parenting plan recommendations • Preparation of extensive written reports focusing on recommendations to the court in regard to custody visitations or parenting plans for minor children • Completed detailed interviews of parents, children and collateral contacts to determine the parenting potential and capacity of adults while advocating for the best interests of the children ·• Served as expert witness to the court as Pierce County Mental Health Professional for determining the patient's danger to self, danger to others, or grave disability under the Civil Commitment Act
ASSESSMENTS (CHILDREN)
• Completed over 1500 individual psychological assessments of children from preschool through age 21, including behaviorally disabled, communication disordered, autistic, traumatic brain injured, orthopedically impaired, hearing impaired, deaf, visually impaired, ADHD, Tourette's Syndrome, and developmentally delayed students • Performed as multidisciplinary team (MDT) leader for individual case study in evaluating students' emotional, social, physical, medical and academic functioning • Consulted with private and public practitioners and agencies regarding students' academic, medical, and sociaVemotional progress
PR/Award# S215E140513 6 Page e53 • Participated as ongoing district liaison with multidisciplinary team, including attending intake interviews and staffings for students in need of residential placement
ASSSESSMENTS (ADULTS)
• Completed hundreds of psychological evaluations with adults female felons, including personality, cognitive and vocational assessments • Assessments of developmentally delayed adults including cognitive, self help, social/emotional, behavioral, academic and adaptive skills • Practicum at Psychological Service Center afforded opportunities for assessing out patient population in regard to intellectual, personality, vocational and neuropsychoJogical assessments • Involved with specialized mental health evaluations assessing psychiatrically indigent individuals for detention and hospitalization under the Civil Commitment Act • Provided in-service training to group home staff in regard to managing the cycle of acting out behavior and the use of gentle teaching techniques in implementing positive programming for developmentally delayed adults • Required considerable crisis intervention skill and expert court testimony for individuals detained and found to be a danger to self, others, or gravely disabled as a result of a mental disorder • Completed assessments of learning disabilities in college-age population
NEUROPSYCHOLOGICAL ASSESSMENT
• Provided neuropsychological evaluation for children and adolescents referred to Primary Children's Medical Center, Salt Lake City, Utah • Received supervision of neuropsychological assessment of adult parolees at Psychological Service Center • Coordinated all neuropsychological sta:ffings with Mary Bridge Children's Nemodevelopmental Team, private clinical neuropsychologists, Good Samaritan Cognitive Rehabilitation staff, and Children's Orthopedic Hospital
PSYCHOTHERAPY
• Served as psychotherapist focusing on individual, group and family-child therapy with adult female felon population • Supervised practicum training with adults and children, including consultation, individual and marital therapy • Supervised praeticum training in college counseling center providing psychotherapy with individual and groups for students seeking emotional, social, academic, and vocational support • Cognitive-behavioral psychotherapy with agoraphobic clients
PR/Award# S215E140513 7 Page e54 • Brief solution-focused and cognitive-behavioral therapies with children and adolescents • Developed and implemented behavior management programs for students
CONSULTATION
• Consultation services provided agencies and schools to outpatients through Psychological S~rvice Center • Behavioral consultation liaison as School Psychologist with educators, parents, students, medical referrals and hospitals for school-based clinical population • Consultative services provider to counseling testing staff regarding learning disabilities assessments • Consultations with multidisciplinary teams regarding difficult placement issues or the need for residential placement for emotionally disturbed students • Consultation provided to the courts, attorneys, children and parents as Guardian Ad Litem • Consultation provided hospitals, psychiatrists, and crisis teams regarding hospitalization of chronically mentally ill population • Consultation with correctional staff regarding treatment planning for incarcerated adult female felons
ADMINISTRATION
• Hired, evaluated and directly supervised psychologist, occupational therapists, physical therapists, speech and language pathologist, and vision specialist • Prepared and submitted state and federal reports • Served as member of the Superintendent's Cabinet • Prepared and wrote Board policy and procedures for special education • Presented in-service training for administrators on special education law and discipline procedures • Wrote, managed, and implemented grants • Preparation and administration of budgets • Managed budgets in excess of 4 million dollars, including projections for upcoming year, budget revisions, and end-of-year reports
SELECTED TRAINING
• Assessment of Violent and Potentially Violent Youth in the Schools • Administration and interpretation of the WISC-IV • Providing Alternative Programs for Students with Severe Behavior Disorders
PR/Award# S215E 140513 8 Page e55 • Assessment of Suicidal Behaviors in Adolescents and Adults: Standards of Clinical Practice • Current Trends in the Diagnosis and Treatment of PTSD: Forensic Applications • Ncuropsychology of Schlzophfenia • Civil Forensic Applications of the MMPI-2 • Advances and Applications in Clinical Neuropsychology • Competency to Stand Trial: Review and Update • Civil Commitment: Clinical and Legal Aspects • Diagnosis and Treatment of ADHD • Diagnosis and Treatment of Agoraphobia • Criminal Insanity: Definition and Practice • Psychopharmacology • Rational-Emotive Therapy/Rational-Effectiveness Training • Managing Marital Therapy - An Integrative Cognitive Behavioral Approach • Psychodrama • Prochaska & DiClemente's Six Stage Model of Change • Neurotic Messages and Boundary Issues in Psychotherapy • Fundamentals of Pediatric Traumatic Brain Injuries • Autism: creating Effective Programs for Students Who Are Low Functioning
PROFESSIONAL MEMBERSHIPS
• American Psychological Association • W ashlngton State Association of School Psychologists • National Association of School Psychologists
PR/Award# S215E140513 9 Page e56 PR/Award# S215E140513 Page e57 Budget Narrative File(s)
• Mandatory Budget Narrative Filename: LS Budg e t Na rrati ve ESSC uploaded 4-28-14 . pdf
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PR/Award# S215E140513 Page e58
Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00 Chief Leschi School Partnership for Improved elementary grades mental health services
Elementary "Paddling Together" ESSC grant budget outline. - Initial draft,. 4-23-14 Fringe Rate Estimates: (approximate amounts, need to confirm salary amount estimates and fringe rates Regular staff: 30% Supplemental: 17% Subs: 10% Project staff positions: A sufficient number of personnel are identified to provide appropriate capacity to serve the high needs participants identified in the proposal. Staff and contracted personnel under the grant will coordinate closely with the counseling staff already present in the school.
Personnel Total Salary Fringe
Part-time Project Manager compensated through this project at no more than 4% of the grant amount, will be supervised by an in-kind Project Director (10% fte equivalency). This management team will be supplemented by (in-kind) additional governance and management capacity represented by the Building Principals, and constituency groups, e.g., the Building Leadership Team. 15,925 12,250 3,675 (4% of grant amount maximum funding through this grant budget)
1.0 fte Social Worker . will provide direct supports and case management for elementary level students to improve access to school and community physical and mental health services both during the school year and during critical periods over extended holidays. and school breaks; will consult with existing school counselors to promote student success. and wellbeing through building school and community partnerships for onsite 81,120 62,400 18, 720 "wraparound" services.
.5 fte, Community Relations and Outreach Coordinator, military family focus with additional partnership coordination functions - bachelors level with Media and 35,750 27,500 8,250 Community relations experience in educational settings.
PR/Award# S215E140513 Chief Leschi Schools ESSC Budget ~e~fu'e 4-28-14 Page 1 Chief Leschi School Partnership for Improved elementary grades mental health services
44,655 34,350 10,305 .5 fte School Psychologist with clinical experience and training: (.8 fte to close existing gap, see additional .3 contracted support, below). Onsite support and consultation for three tier planning and implementation; direct service to high needs students including treatment/counseling, evaluation and program planning
.5 (B-RTI) Mental Health Provider will provide mental health assessments, behavioral interventions, crisis response, and positive behavioral supports and Behavioral Response to Intervention services. In addition to direct services and consultation, in-service training and coaching for instructional staff and Paraeducators in recognizing and supporting student mental health needs will be provided. This individual will train and coach classroom staff in Second Step -a social and emotional skills curriculum for all elementary students; will train and coach classroom staff in Safe and Civil Schools- for positive and proactive classroom management; will train and manage the. Check and Connect student-school connection program as well as related positive behavioral 44,655 . 34,350 J 0,305 supports. '--.:....:__~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
PR/Award# S215E140513 Chief Leschi Schools ESSC Budget ~e~fu'e 4-28-14 Page 2 Chief Leschi School Partnership for Improved elementary grades mental health services
Extended contract staff professional development: Certified elementary school staff will receive supplemental contracted hours to support project activities through professional development.. Staff will include teachers and para educators, Cost are estimated given cun-ent average pay rates and expected contracted hours needed given the scope of work. These supplemental contracts will include. culture and Native language staff. It is. paramount that services provided under this project be culturally relevant. Initial trainings will be aligned with job-embedded ongoing coaching and follow-up training for all teachers and paraeducators provided by project staff in cooperation with existing school counselors, e.g., Second Step; Safe and Civil Schools; Check and Connect; Recognizing and responding to mental health concerns - release time costs for substitute teachers and paraeducators for individual/small group training/coaching, classroom observations:
Certified supplemental contracts: Summer and after school professional development $25/hour x 45 hours x 25 trainees
. 32,906 .28,125 .4,781 . Salary: $28,125
. Classified supplemental contracts: Summer and after school professional development $20/hour x 45 hours x 25 trainees 26,325 22,500 3,825 Salary: $22,500
281,336 221,475 59,861 PERSONNEL TOTALS
PR/Award# S215E140513 Chief Leschi.Schools ESSC Budget ~e~tjye.4-28-14 . . Page 3 Chief Leschi School Partnership for Improved elementary grades mental health services
(line item Travel Total amounts) Travel
Most Chief Leschi students are bussed to school daily. We serve a large geographic area from inner-city to fringe metropolitan areas .. Most of the activities through the school year will be school-based programs and additional transportation costs will not be needed. Transportation will be. necessary for the additional proposed project activities and events, e.g. transport of students and parent/guardian to appointments, e.g., for evaluations and services, and activities including for summer activities that cannot rely on daily transportation to and from school.
Local travel necessary to support inter-school (Grandview - WaHeLut - CLS) home visits and community travel for Social Worker and other project staff
Vehicle lease: estimatimated costs: 12 months, average 1250 miles per . 8,400 month times .56 per mile and $450 per month lease cost (GSA rates).
Additional local mileage, e.g., periodic transport of students to appointments at local provider partners, e.g., Kwawachee Mental Health and 2,250 Good Samaritan Behavioral Health.
Supplemental student transportation for after school, critical periods and 2,350 special needs e.g. local Mental Health providers:
Attendance at Project Directors Meeting in Washington, D.C. or other conference travel for 2 staff members (coordinator/director) for 2 days: Estimate: RT Airfare X 2 staff and Hotel - X 3 nights X 2 or three regional . 2,400 workshops: est. cost 15,400
PR/Award# S215E140513 Chief Leschi Schools ESSC Budget ~e~~e 4-28-14 Page 4 Chief Leschi School Partnership for Improved elementary grades mental health services
Supplies Total Supplies: 2,000 Safe and Civil Schools CHAMPS manuals: 2,000 . 5,000 . e.g., Second Step teacher manuals:. 5,000 2,000 Academic & behavioral program incentives and related curriculum 575 General program support supplies I materials: 500 5,500 After-school and summer student program support, e.g., . 1,500 . Cultural I language. activities with pro-social 7,500 Family and parent involvement materials, e.g., "make and take" 750 Community outreach materials, 500 24,825
Equipment Total Equipment: CLS video camera upgrades and increased coverage: safe school 20,000 environment as part of anti-bullying and school safety improvements
4,500 Related equipment, e.g., access controls 24,500
PR/Award # S215E140513 Chief Leschi Schools ESSC Budget ~e~tn'e 4-28-14 Page 5 Chief Leschi School Partnership for Improved elementary grades mental health services
Contractual Total Contractual
Child Psychiatric Consultation: (.125. fte to close existing gap) Increase access and decrease lag time for student mental health evaluations, recommendations and team participation, including neurobehavioral, ADHD, PDD spectrum and FAE/FAS spectrum concerns; also provide 14,950 consultation to project participants Contracted Culturally (Coast Salish) based behavioral supports and interventions, e.g., oral tradition and traditional healing: Works closely with mental health providers, particularly Takopid Health partnership and school counseling staff to provide school day/after school program for students that respond to traditional supports, e.g., "Circle of Life", social stories, 9,500 friendship circles, and oral tradition problem solving
Additional contracted clinically trained School Psychologist with proven clinical experience (Total .8 fte to close existing gap, see additional .5 salaried support, above: Onsite support and consultation for three tier planning and implementation; direct service to high needs students including 24,950 treatment/counseling, evaluation and program planning
External Evaluator: Given the scope of work identified in the narrative, first 4,500 year costs of 75 hours at $60 hour are estimated. 53,900 Indirect Costs: $0 Chief Leschi has received an administrative cost rate from the Department of Interior that is approximately 13.63% .. We do not utilize negotiated or non-negotiated cost rates. However,. in the interest of directing as much grant support to the project direct services as possible, no. indirect or general administrative costs are requested 399,961 TOTAL COSTS
PR/Award# S215E140513 Chief Leschi Schools ESSC Budget ~e~tWe 4-28-14 Page 6 Chief Leschi School Partnership for Improved elementary grades mental health services
YEAR TWO AND THREE COSTS: Project costs for years two and three "level funded" as per application guidelines. While second year needs may be somewhat lower due to the lower "startup" costs, the effects of inflation and cost of living may raise costs. Adjustments will be made; for example, to the external evaluation costs, as determined by the review of the first year outcomes and data compilation and reporting needs.
PR/Award# S215E140513 Chief Leschi Schools ESSC Budget ~e~fu'e 4-28-14 .Page 7 U.S. DEPARTMENT OF EDUCATION OMB. Number: 1894-0008 BUDGET INFORMATION Expiration Date: 04/30/2014 NON-CONSTRUCTION PROGRAMS
Name of Institution/Organization Applicants requesting funding for only one year. should complete the column under "Project Year 1." Applicants requesti ng funding for multi-year grants should complete all Puyallup Tribe of I ndians !chief Lesch i Schools of the I applicable columns. Please read all instructions before completing form. SECTION A - BUDGET SUMMARY U.S. DEPARTMENT OF EDUCATION FUNDS
Budget Project Year 1 Project Year 2 Project Year. 3 Project Year 4 Project Year 5 Total (a) (b) (c) (d) (e) (f) Categories 1. Personnel 221, 475 . 001 221, 475 . 001 221. 475 . ool 1 I 664, 425 . 001 2. Fringe Benefits 59, 861. ool 59, 861 . ool 59' 861. 001 1 I 179, 583 . ool 3. Travel 15, 400 . ool 15, 400 . ooj 15, 400 . ooj I I 4 6, 200 . ool 4. Equipment 24 , 500 . 001 24 , 500 . 001 24 , 500 . 001 1 I 73, soo . ool 5. Supplies 24, 825 . 001 24 , 825 . ool 24 , 825 . ool 1 I 74 , 475 . 001 6. Contractual 53, 900 . 001 53, 900 . 001 53, 900 . 001 1 I 161, 100 . ool 7. Construction I I I I I 8. Other I I I I I 9. Total Direct Costs . 399, 961 . ool I 399, 961 . ool I 399' 961. 001 1 1, 199, 883 . 001 !lines 1-8) I I I 10. Indirect Costs* I I I I I 11. Training Stipends I I I I I 12. Total Costs . 399, 961 . ool I 399, 961 . ool 399, 961. ool 1 1, 199, 883 . 001 llines 9-11) I I I I
*Indirect Cost Information (To Be Completed by Your Business Office): If you are requesting reimbursement for indirect costs on line 10, please answer the following questions:
(1 ) Do you have an Indirect Cost Rate Agreement approved by the. Federal government? 0 Yes 0 No (2) If yes, please provide the following information: Period Covered by the Indirect Cost Rate Agreement From: I I To: I I (mm/dd/yyyy) Approving Federal agency: O ED D Other (please specify): I I The Indirect Cost Rate is I 1%. (3) For Restricted Rate Programs (check one) ··Are you using a restricted indirect cost rate that: D Is included in your approved Indirect Cost Rate Agreement? or, 0 Complies with 34 CFR 76.564(c)(2)? The Restricted Indirect Cost Rate is I I O/o.
PR/Award # S215E1 40513 ED Form No. 524 Page e66
Tracking Ntunber:GRANTI 1638534 Fw1ding OpportW1ity Number:ED-GRANTS-031214-001. Received Date:2014-04-28Tl5:3 l :37-04:00 Name of. Institution/Organization Applicants requesting funding for only one year Ch i e f Leschi School s of the Puyallup Tri be of Indi ans should complete the column under "Project Year 1." Applicants requesting funding for multi-year grants should complete all applicable columns. Please read all instructions before completing form.
SECTION B - BUDGET SUMMARY NON-FEDERAL FUNDS
Project Year 1 Project Year 2 Project Year 3 Project Year 4 Project Year 5 Budget Categories Total (a) (b) (c) (d) (e) (f) 1. Personnel I 2. Fringe Benefits
3. Travel
4. Equipment
5. Supplies
6. Contractual
7. Construction
8. Other 9. Total Direct Costs !lines 1-81 11 10. Indirect Costs
11. Training Stipends 12. Total Costs (lines 9-11} SECTION C - BUDGET NARRATIVE (see instructions)
ED Form No. 524
PR/Award # S215E140513 Page e67
Tracking Ntunber: GRANTI 1638534 Fw1ding OpportW1 ity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:3 l :37-04:00 OMB Number: 1894-0007 U.S. DEPARTMENT OF EDUCATION Expiration Date: 07/31 /2014 SUPPLEMENTAL INFORMATION FOR THE SF-424
1. Project Director:
Prefix: First Name: Middle. Name: Last Name: Suffix: 11.____No<.. o _ II.______,ll.____Do Address: Street1: ls625 52nd St ., E Street2: ::======~ City: !Puyallup County: :::::======: State: l1vA : lvashi ngton Zip Code: 198422-3610 Country: lusA : UNITED STATES Phone Number (give area code) Fax N umbe~ (give area code) 1253- 606- 7578 Email. Address: lnorm@leschi schools . org 2. Novice Applicant: Are you a novice applicant as defined in the regulations in 34 CFR 75.225 (and included in the definitions page in the attached instructions)? D Yes D No ~ Not applicable to. this program 3. Human Subjects Research: a. Are any research activities involving human subjects planned at any time during the proposed project Period? D Yes ~ No b. Are ALL the research activities proposed designated to be exempt from the regulations? D Yes Provide Exemption(s) #: IL..------' D No Provide Assurance#, if available: _1------~ c. If applicable, please attach your "Exempt Research" or "Nonexempt Research" narrative to this form as indicated in the definitions page in the attached instructions. Add Attachment Delete. Attachment I View Attachment PR/Award# S215E140513 Page e68 Tracking Number:GRANTI 1638534 Funding Opportunity Number:ED-GRANTS-031214-001 Received Date:2014-04-28Tl5:31:37-04:00